Table 4 Illustrative quotes for the substance use/driving perceptions and experiences theme from focus groups and user testing

Previous education on and experience with risky driving

Focus Groups

“People don’t go into a lot of depth about explaining it. They just say don’t do it.

“I think especially with driver’s ed, they have to put the drunk goggles on and walk around and try to do tasks.”

“And they just told us not to do it, and they had us do fun activities. And then after each activity they just said, don’t do it.”

“I honestly don’t remember being talked to about driving under the influence of cannabis.”

“Sometimes it’s very difficult, though, especially when someone’s older than you.”

“Or if you’re in a car and the car is full of people and no one thinks that it’s wrong except for you, it’s kind of hard to make everyone think it’s wrong.”

Availability and use of alcohol and cannabis

Focus Groups

“I think it’s [cannabis] a lot more common than alcohol”

“I think it’s [cannabis] sort of normalized a lot. I think it’s a lot more normalized in our generation than before, because of legalization.”

“It’s just easier to access it [cannabis].”

“I would say it’s [cannabis] more [common] than drinking alcohol in the State of Colorado, if you ask me. I would say it’s more than drinking alcohol because teens just seem to do it more.”

“People that are already vaping, they get bored eventually from whatever, and then they start smoking cannabis, too, or they mix both of them.”

“I would say it’s easier to hide smoking than drinking.”

User Testing

Alcohol is worse [than cannabis].

One or the other [alcohol or cannabis], not common to do both [alcohol and cannabis]

You drink first and then smoke; you don’t smoke and then drink.

Preference for one over the other usually, it’s not as common to combine both, “cross-faded” is a horrible experience and not to do it.

People view cannabis differently than alcohol and view it as safer.

People believe that cannabis actually makes you more attentive and this is a common misconception in her age group.

More people drink but recognize that it’s not a safe behavior to do while driving, whereas with cannabis it feels like more of a gray area and less “overtly” bad.

More fear around “what is in it” when it comes to cannabis, especially edibles – feels less controlled so alcohol may feel more natural.

Perceived rates of substance use in peers

Beliefs about driving under the influence

User Testing

In public and private schools, felt drug and alcohol abuse was prevalent and that teens often combined frequently.

A lot of the population at his school uses both but not his friend group.

Feels like there are a handful of people who engage weekly, and that most drive afterward.

People use them at parties, using them together often, and older siblings as a bad influence

Focus Groups

“I think that it’s not as common as it used to be… there’s a lot of fear instilled in this generation about drunk driving.”

“I think it happens a lot of the times when cops show up because people just freak out and they have to just leave. So then there’s a lot of drunk driving there.”

“I also think even people who say they’re going to be a designated driver, they get peer pressured into drinking, too. And you don’t have your designated driver.”

“At least in my city, I know that a lot of my friends and people I know, in general, if we know someone’s drunk, we don’t let them drive… So it’s not that frequent, for me at least.”

“Football games and dances, school dances it [DUI] happens all the time.”

“That’s where the main thing happens because people get drunk or high. And then they go to a dance, and then they drive to the afterparties.”

“I think it’s more than you guys know. I think a lot of teens do it more than you guys think drink or use drugs while driving”

“I feel like teenagers always think, like, they’re kind of invincible in a way. They think nothing bad is going to happen, so they just take the chance and take the risk. So I think that’s why so many teens drink while under the influence or drive when under the influence.”